Provider Demographics
NPI:1376861682
Name:SAVOIE, KIM J
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:J
Last Name:SAVOIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:J
Other - Last Name:SAVOIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MT
Mailing Address - Street 1:24 DEALLYON AVE
Mailing Address - Street 2:18
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-6201
Mailing Address - Country:US
Mailing Address - Phone:843-422-5517
Mailing Address - Fax:
Practice Address - Street 1:24 DEALLYON AVE
Practice Address - Street 2:18
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-6201
Practice Address - Country:US
Practice Address - Phone:843-422-5517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6367225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist